REFERENCE · RECOVERY TECHNIQUE
Considering an Online ACT Group
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Background: Everything We Know About FCD — the concepts behind this page.
When this may fit: When a person wants therapist-led help with symptom interference and valued activities, and an appropriate group is available. [Emerging evidence; randomized feasibility study, not proof of efficacy]
For the Person With FND
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For the Person With FND
Acceptance and commitment therapy, or ACT, can help people make room for difficult thoughts and feelings while taking part in things they value. “Acceptance” does not mean agreeing that symptoms are imaginary, giving up medical care or being content with poor support.
A manageable way to begin
- Ask whether the group is suitable for your assessed difficulties, what it involves and what help is available between sessions.
- Discuss access needs before joining: screen tolerance, hearing, breaks, written reminders, privacy and whether a supporter may help.
- Choose a small activity linked to something you value. A therapist may help you notice a discouraging thought without letting it make every decision.
- Review whether the group is useful and tolerable. You can request adaptations or a different form of care.
Keeping the approach helpful
This page describes an emerging treatment option, not a self-directed copy of a trial. In a 44-person randomized feasibility study, ACT plus usual care was compared with usual care. It supported further study, not a reliable estimate of benefit. Satisfaction with memory improved more clearly than perceived memory ability. A group may not suit everyone. [1]
During a familiar flare
If a session or inward-focused exercise makes symptoms or distress worse, tell the therapist. Ask to pause, use an external focus or review the format. Missing a session does not make you responsible for ongoing symptoms.
When to seek assessment
Sudden new confusion, altered consciousness, or cognitive difficulty with new weakness, speech change, severe headache, fever, a seizure or head injury needs urgent medical assessment. New difficulty recognizing highly familiar people, progressive loss of familiar knowledge, major visual-spatial change, progressive decline, getting lost in familiar places, unsafe medication or financial errors, or a marked change from your usual pattern also needs review. Pause safety-sensitive activities when you cannot manage them safely. Existing FCD does not explain every new symptom.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
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For Family, Friends, and Other Supporters
Ask what practical help would make attendance easier. Do not use “acceptance” to argue against accommodations or further medical review. Let the person decide what to share about a group discussion.
During a familiar flare, use one speaker and one idea at a time. Give processing time and offer the person’s usual aids. Preserve dignity and choice; ask before taking over. If the pattern is new or severe, follow the medical plan instead of continuing a recovery exercise.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
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For Clinicians and the Care Team
The trial tested five online group sessions alongside treatment as usual. It was not powered for efficacy; follow-up attrition and a small sample limit conclusions. Agree goals around participation, psychological flexibility and burden, without promising cognitive restoration. Assess suitability, accessibility and adverse effects and preserve usual clinical care. [1]
Agree a written next step, accessible prompts and a review point. Assess symptom burden, daily function, support needs and adverse effects. FCD is a positive clinical diagnosis; normal tests alone, a good moment or the response to an exercise cannot establish it. Practical assistance should continue when symptom improvement is limited. See the paired diagnostic page.
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
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Research and Sources
Benefit from ACT would not establish that psychological factors, beliefs or excessive monitoring caused FCD. Package-level findings also cannot establish which component helped.
This page expands original entry 11, Online group ACT. Everyday examples are illustrations, not patient quotations. Practical steps are educational adaptations of the clinical approach; they are not a reproduced trial protocol or an individually validated treatment. Evidence for a whole programme must not be transferred to each component.
| Citation | Source | What it supports and its limits | Figure |
|---|---|---|---|
| 1 | FND-CIT-0036 — Poole N, Cope S, Vanzan S, et al. Randomised controlled feasibility trial of online group acceptance and commitment therapy for functional cognitive disorder. BJPsych Open. 2025;11(3):e91. DOI. | Small randomized feasibility study; not a definitive efficacy trial. | — |
Source review: September 21, 2026 · Cognitive-neurology, neuropsychology, lived-experience and accessibility review pending
For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources
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